Organization
ASHLEY CLINIC, LLC
Active
Parent organization
ASHLEY CLINIC, LLC
Other names
Ashley Clinic Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASHLEY CLINIC, LLC
Authorized official
DR. ROBERT K THOMEN II MD (PHYSICIANOWNER)
(620) 431-2500
Entity
Organization
Contact information
Practice address
505 S PLUMMER AVE, CHANUTE, KS 66720-1950
(620) 431-2500
(620) 431-4418
Mailing address
PO BOX 946, CHANUTE, KS 66720-0946
(620) 431-2500
(620) 431-4418
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080330K
—
KS
01
—
23411
BLUECROSS BLUESHIELD
KS
01
—
690005399
RAIL ROAD MEDICARE
—
Enumeration date
11/08/2006
Last updated
05/06/2015
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